2024 R.R. LALENA BUYER'S GUIDE

BILL TO COMPANY Name Address City State Zip Business Telephone Number Business Fax Number Type of Business Number of Years in Business Accounts Payable Manager Business Type Partnership Corporation Principal Name Address City State Zip Country Telephone Number Fax Number Social Security Number Bank References Bank Name Office Name Address City State Zip Bank Telephone Number Checking Account Number OPEN ACCOUNT TERMS Open Account Terms are net 14 days F.O.B. shipping point. Interest at 2% monthly on all past due invoices. We accept the terms shown above and authorize you to obtain information from the references listed. NOTE: There will be a $40 service charge on all returned checks. DO YOU PREFER C.O.D. SHIPMENTS? Yes No TRADE REFERENCES (Give Supplier’s Complete Address) Name Address City State Zip Business Telephone Number Business Fax Number Account Number Name Address City State Zip Business Telephone Number Business Fax Number Account Number Name Address City State Zip Business Telephone Number Business Fax Number Account Number How did you hear about R.R.Lalena? Catalog Internet Advertisements Tradeshow Referred by Someone Other APPLICATION FORM FOR TERMS MUST BE FULLY COMPLETED IN ORDER TO BE PROCESSED Please Be Sure To Fill Out Both Sides Online Account Registration E-Mail Address: User ID: Password: Job Position: Max. 16 Characters 6 - 10 Characters 59-26 55th Drive Maspeth, NY 11378 USA 1.800.R.LALENA 718.326.9788 718.326.8765 R.R. LALENA CORPORATION RRLALENA .com